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Antimicrobial Agents and Chemotherapy, May 2002, p. 1199-1203, Vol. 46, No. 5
0066-4804/02/$04.00+0     DOI: 10.1128/AAC.46.5.1199-1203.2002
Copyright © 2002, American Society for Microbiology. All Rights Reserved.

Emergence of Group A Streptococcus Strains with Different Mechanisms of Macrolide Resistance

Edouard Bingen,1* Roland Leclercq,2 Frédéric Fitoussi,1 Naïma Brahimi,1 Brigitte Malbruny,2 Dominique Deforche,1 and Robert Cohen3

Service de Microbiologie, Hôpital Robert Debré, Paris,1 Service de Microbiologie, CHU Côte de Nacre, Caen,2 Service de Microbiologie, Centre Hospitalier de Créteil, 94010 Créteil, France3

Received 26 July 2001/ Returned for modification 3 October 2001/ Accepted 24 January 2002

The mechanisms of resistance to macrolides in seven group A streptococcal (Streptococcus pyogenes) isolates that were the cause of pharyngitis in children who were unsuccessfully treated with azithromycin (10 mg/kg of body weight/day for 3 days) were evaluated. All posttreatment strains were found to be genetically related to the pretreatment isolates by random amplified polymorphism DNA analysis and pulsed-field gel electrophoresis. Two isolates had acquired either a mef(A) or an erm(B) gene, responsible for macrolide efflux and ribosomal modification, respectively. Three isolates displayed mutations in the gene encoding the L4 ribosomal protein that is part of the exit tunnel within the 50S subunit of the bacterial ribosome. In the two remaining posttreatment strains, the mechanisms of macrolide resistance could not be elucidated.

* Corresponding author. Mailing address: Service de Microbiologie, Hôpital Robert Debré, 48 Blvd. Sérurier, 75019 Paris, France. Phone: 33 1 40 03 23 40. Fax: 33 1 40 03 24 50. E-mail: edouard.bingen{at}rdb.ap-hop-paris.fr

Antimicrobial Agents and Chemotherapy, May 2002, p. 1199-1203, Vol. 46, No. 5
0066-4804/02/$04.00+0     DOI: 10.1128/AAC.46.5.1199-1203.2002
Copyright © 2002, American Society for Microbiology. All Rights Reserved.



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